News & Commentary

Variation Found In Prisons, Too

Unexplained variation in health care costs among America’s regions and states has long been a puzzle for providers and payers, and it seems to be a problem for prisons as well, according to a study by the Pew Charitable Trusts. “Health care spending per inmate varied dramatically in fiscal 2015, as it had in past years—from $2,173 in Louisiana to $19,796 in California,” the report states.

Pew researchers could not determine what exactly causes the variation. One obvious possibility: States that spend less to provide health care might not be giving prisoners adequate care.

“State officials across the country need to understand whether and how these differences reflect meaningful discrepancies in value and performance,” the Pew report said.

It’s important to know exactly how the money is spent, information that’s not currently available, according to researchers. That’s in part because most state data systems don’t offer enough to create a detailed, actionable analysis. And reporting limitations were most common among states that primarily or completely outsource their prison health care delivery, the report states.

State corrections departments spent $8.1 billion on prison health care services in 2015, representing about a fifth of overall prison expenditures.

It took decades of litigation to establish that prison health care must be close to the level of care that non-prisoners receive.

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